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Rates of referable eye disease in the Scottish National Diabetic Retinopathy Screening Programme
H C Looker1, S O Nyangoma1, D T Cromie2
1University of Dundee, Dundee, UK.
The British Journal of Ophthalmology
|March 7, 2014
Summary
Diabetic retinopathy screening referrals stabilized, with maculopathy being the most common reason. Despite low retinopathy rates, ophthalmology workload increases due to new treatments, suggesting a review of maculopathy referral pathways.
Area of Science:
- Ophthalmology
- Public Health
- Diabetology
Background:
- Diabetic retinopathy screening aims to prevent visual loss by detecting proliferative diabetic retinopathy and suspected maculopathy.
- Initial concerns existed regarding the manageability of ophthalmology referral rates upon screening program introduction.
Purpose of the Study:
- To report the yield of referable disease by referral reason over the first five years of a nationwide diabetic retinopathy screening program.
- To analyze trends in referral rates and identify the primary drivers of ophthalmology workload.
Main Methods:
- Data extracted from a nationwide clinical diabetes database (2006-2010).
- Calculation of annual referral rates to ophthalmic clinics.
- Logistic regression used to examine associations between clinical measures and referable disease.
Main Results:
- Over 182,000 individuals underwent retinal screening.
- The highest yield of referable eye disease occurred in the first two years (7.0% and 6.0%), stabilizing around 4.3%.
- Maculopathy became the predominant referral reason, accounting for 73% of referrals in 2010.
Conclusions:
- Suspected maculopathy is the most frequent cause for referral in diabetic retinopathy screening.
- Referral rates for retinopathy have stabilized at low levels as predicted.
- Ophthalmology workload is increasing due to new treatments like monthly intraocular injections, necessitating a review of maculopathy referral pathways.
